Langner Marini, Machado Rodrigo Strehl, Patrício Francy R S, Kawakami Elisabete
Pediatric Gastroenterology Division, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo / Escola Paulista de Medicina" (UNIFESP/EPM), São Paulo, SP, Brazil.
Arq Gastroenterol. 2009 Oct-Dec;46(4):328-32. doi: 10.1590/s0004-28032009000400015.
Although Helicobacter pylori infection is prevalent in our country, there are few studies evaluating the associated histological abnormalities in children.
To evaluate the histological features of the gastric mucosa in children and adolescents with Helicobacter pylori gastritis.
One hundred and thirty two gastric biopsies from 22 symptomatic patients infected with H. pylori (14F/8M, median age 10 y 5 mo, age range 2 y 11 mo to 16 y 9 mo) were evaluated. Evaluated gastric regions included: antrum (lesser and greater curvature), corpus (lesser and greater curvature), incisura angularis and fundus. Histological examination was performed according to the Updated Sydney System, and regional scores for polymorphonuclear and mononuclear cell infiltrate as well as bacterial density were generated.
Fifteen (68.2%) patients presented H. pylori-chronic active gastritis, six (27.3%) presented antrum-predominant H. pylori-chronic active gastritis, and one (4.5%) presented corpus-predominant H. pylori-chronic active gastritis. Polymorphonuclear cell infiltrate and mononuclear cell infiltrate were observed in 93.9% and 98.5% of the biopsy specimens, respectively. Higher histological scores for polymorphonuclear infiltrate, mononuclear infiltrate, and bacterial density were observed in the gastric antrum. Intestinal metaplasia and gastric atrophy were not identified in any patient. Lymphoid aggregates and lymphoid follicles were observed in the gastric antrum of three (13.6%) and seven (31.8%) patients, respectively, but they were not related to antral nodularity.
Chronic active gastritis was observed in all patients with H. pylori infection. However, antral or corporeal predominance was not observed in most patients.
尽管幽门螺杆菌感染在我国很普遍，但评估儿童相关组织学异常的研究较少。
评估幽门螺杆菌胃炎患儿及青少年胃黏膜的组织学特征。
对22例有症状的幽门螺杆菌感染患者（14例女性/8例男性，中位年龄10岁5个月，年龄范围2岁11个月至16岁9个月）的132份胃活检标本进行评估。评估的胃区域包括：胃窦（小弯和大弯）、胃体（小弯和大弯）、角切迹和胃底。根据更新的悉尼系统进行组织学检查，并得出多形核细胞和单核细胞浸润以及细菌密度的区域评分。
15例（68.2%）患者表现为幽门螺杆菌慢性活动性胃炎，6例（27.3%）表现为以胃窦为主的幽门螺杆菌慢性活动性胃炎，1例（4.5%）表现为以胃体为主的幽门螺杆菌慢性活动性胃炎。分别在93.9%和98.5%的活检标本中观察到多形核细胞浸润和单核细胞浸润。胃窦中多形核浸润、单核浸润和细菌密度的组织学评分更高。所有患者均未发现肠化生和胃萎缩。分别在3例（13.6%）和7例（31.8%）患者的胃窦中观察到淋巴聚集和淋巴滤泡，但它们与胃窦结节无关。
所有幽门螺杆菌感染患者均观察到慢性活动性胃炎。然而，大多数患者未观察到胃窦或胃体为主的情况。
